| NPI | 1205967569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M6430) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 044835) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-08-08 |